Tuesday, 8 May 2012
The Best Way of Handling Surgical Scissors
The Best Way of Handling Surgical Scissors Focus Surgical scissors isn’t just a good medical tool for sharp cutting, surgical scissors with suitable tips are ideal for blunt dissection by spreading, ranking or probing.Focus Surgical scissors have an added advantage over a clamp for blunt dissection, because alternating sharp & blunt dissection can be done without switching back and forth your medical instruments. Blunt dissection separates tissue layers themselves. If you see any cementing substance it may be scar tissue from an earlier surgery or normal areolar tissue as in between fascial layers. Be aware of hurdles when cutting through the differnet sections of scar tissue, espically where the scar tissue comes in together with one of the layers. Blunt cutting of adhesions between layers proves risky when the adhesions have more tensile strength than the bound layers. A scar may bind bowel to fascia or parietal pericardium to the heart with greater tensile strength than is present in the bowel or in the interior the myocardium. Blunt cutting in these cases may be inappropriate and can result in an unintended enterostomy or entry in the myocardium. This is why its risky for blunt cutting where you see some old scares come together with natural planes or where dense scar tissue is stronger than the structures it blinds. Normally when doctors cut using surgical scissors its in direct view. Blind scissors cutting and blunt dissection can sometimes be of enormous advantage & could be accurate and secure. Such blind dissection is done between well-established tissue planes in anatomic regions away from such critical structures as large vessels and nerves. Blind surgical scissor dissection is an excellent way for opening a tunnel just underneath the dermis to put in a heterograft when you make an arterial venous fistula. You can also put blind surgical dissection to work in your favor while doing a breast biopsy through a small circumareolar cut. Often it is difficult to see the deep side of a breast lump; but, by palpation, using the left index finger as a guide, scissors could be used to circumscrive & get rid of the lump. While exposing major blood vessels by blunt cutting with scissors, be sure to express caution when doing this, because you could tear small tributaries and braches. If you use your surgical scissors to make a spread between a major vessel, be sure to focus & not make any tearing of side branches; whereas if spreading is done perpendicular to the great vessel; focus your full attention plaques. Both methods, through having drawbacks, can be used if the inherent problems are understood.